DIABETIC OR CALORIE CONTROLLED
DIET (ADA)
These diets control calories,
carbohydra protein, and fat intake
in balanced amour to meet
nutritional needs, control blood
sugar levels, and control weight.
-Portion control is used at
mealtimes as outlined in the ADA
"Exchange List for Me Planning."
Most commonly used calore levels
are: 1. 200, 1,500, 1,800 and 2,000.
NO ADDED SALT (NAS) DIET
Is a regular diet with no salt packet
on the tray. Food is seasoned as
regular food
LOW SODIUM (LS) DIET May also be
called a 2 gram Sodium Diet.
Limits salt and salty foods such as
bacon, sausage, cured meats,
canned soups, salty seasonings,
pickled foods, salted crackers, etc.
Is used for people who may be
"holding water" (edema) or who
have high blood pressure, heart
disease, liver disease, or first stages
of kidney disease.
LOW FAT/LOW CHOLESTEROL DIET
Is used to reduce fat levels and/or
treat medical conditions that
interfere with how the body uses
fat such as diseases of the liver,
gallbladder, or pancreas.
Limits fat to 50 grams or no more
than 30% calories derived from fat.
Is low in total fat and saturated fats
and contains approximately 250-
300 mg cholesterol
HIGH FIBER DIET
- prescribed in the prevention or
treatment of a number of
gastrointestinal, cardiovascular, and
metabolic diceace.
Fiber Food sources of fiber include
whole wheat, bran, fresh or dried
fruits, and vegetables
-Increased fiber should come from
a variety of cource: Including fruit:.
legume:, vegetable:, whole bread:.
and cereal:
MECHANICALLY ALTERED OR SOFT
DIET
Is used when there are problems
with chewing and swallowing.
Changes the consistency of the
regular diet to a softer texture.
Includes chopped or ground meats
as well as chopped or ground raw
fruits and vegetables.
Is for people with poor dental
conditions. missing teeth, no teeth,
or a condition known as dysphacia
PUREED DIET
Changes the regular diet by
pureeing it to a smooth poliquid
condstency.
- Indicated for those with wired
Jaw: extremely poor dentition in
which chewing is inadequate.
Often thinned down so it can pass
through a traw.
Is for people with chewing or
swallowing difficulties or with the
condition of dysphada.
Food: should be pureed separately.
Avoid nuts, seeds, raw vegetables,
and raw fruits.
Is nutritionally adequate when
offering all food groups.
FOOD ALLERGY MODIFICATION
Food allergies are due to an
abnormal immune response to an
otherwise harmless food
-Foods implicated with allergies are
strictly eliminated from the diet.
Appropriate substitutions are made
to ensure the meal is adequate. The
most common food allergens are
milk, egg, soy, wheat, peanuts, tree
nuts fish, and shellfish.
A gluten free diet would include the
elimination of wheat, rye, and
barley. Replaced with potato, corn,
and rice products.
FOOD INTOLERANCE
MODIFICATION
The most common food intolerance
is intolerance to lactose (m = sugar)
because of a decreased amount of
an enzyme in the bouy. Other
common types of food intolerance
include adverse reactions to certain
products added to food to enhance
taste, color, or protect against
bacterial growth. IHSS Training
Academy 5
-Common symptoms involving food
Intolerances are vomiting. diarrhea,
abdominal pain, and headaches
TUBE FEEDINGS
Tube feeding: are used for people
who cannot take adequate food or
fluid: by mouth.
-All or parts of nutritional need: are
met through tube feedings.
Some people may receive food by
mouth if they can cwallow cafely
and are working to be weaned off
the tube feeding.
DIETARY MANAGEMENT
HYPERTENSION
HYPERTENSION
WHO defines Hypertension as the
condition in which systolic pressure
exceeds 120mm Hg and diastolic
pressure exceeds 95 mm Hg
High blood pressure causes I in
every 8 deaths worldwide, making
it the third leading cause of death
worldwide. Blood pressure is
necessary to move blood through
arteries and provide oxygen to the
tissues of the body When the
diastolic pressure in 100 or more
therapy should be initiated through
drugs as well as diet
High blood pressure, or
hypertension, has no symptoms,
and is often called the "silent killer"
because it can go undetected for
years until a fatal heart attack or
stroke occurs.
This can lead to other health
complications such as stroke,
kidney failure, impaired vision,
heart attack, or heart failure.
DIETARY MANAGEMENT
PRINCIPLES OF DIET
Low caloric, low fat, low sodium
diet with normal protein intake is
prescribed was suggested
This diet is very restrictive diet and
deficient in many nutrients
An obese patient is reduced to
normal body weight with low
calorie diet
About 20 Kcal/Kg-sedentary worker
25 Keal/kg-moderately active
worker
Alcohol consumption should be
reduced
2) PROTEIN
A diet of 60g protein is necessary to
maintain proper nutrition
 In severe hypertension protein
restriction to 20g is required as a
temporary measure since protein
foods are rich in sodium
3) FATS
As they are prone to atherosclerosis
it is advisable to avoid high intake
of animal or hydrogenated fat.
About 20g vegetable oil is
permitted
Omega 3 fatty acids has a role in
regulation of blood pressure
DHA is more potent than EPA
4) CARBOHYDRATE
Easily available carbohydrate is of
great help in managemnet of high
Blood pressure
5) SODIUM
Increased sodium intake leads to
increased intravascular volume and
thus increases cardiac output by
elevating blood pressure
Restricted sodium and decrease in
sodium/potassium ratio in diet
Moderate sodium restriction 2-
3giday reduces diastolic pressure 6-
10mm HG
Soduim restriction accompanied by
weoght reduction effectively
control mild/moderate arterial
blood pressure
6) POTASSIUM
Potassium works with sodium to
regulate the body's water balance.
Low level of potassium cause the
body to retain sodium and water
and this can elevate blood pressure
Research shows that a high
potassium-to-sodium ratio is
associated with a greater
likelihood that normal blood
pressure will be maintained. The
recommended intake of potassium
is 3500mg/day
Instead, potassium rich foods such
as leafy green vegetables, root
vegetables like potatoes and
carrots, and fruit, should be eaten
everyday to meet potassium
requirement
7) CALCIUM
Intake of calcium has blood
pressure lowering effects
It is involved in the control of
strength with which blood is
pumped by the heart and the flow
of blood in the veins and capillaries
both of which conribute the blood
pressure
DASH-DIETARY APPROACH TO STOP
HYPERTENSION
The DASH diet is rich in fruits,
vegetables, whole grains, and low-
fat dairy foods; includes meat, fish,
poultry, nuts and beans; and is
limited in sugar-sweetened foods
and beverages, red meat, and
added fats. > It is a dietary pattern
promoted by the U.S.-based
National Heart, Fruits and Lung, and
Blood Institute to prevent and
control hypertension.
DASH is a flexible and balanced
eating plan. It has been proven to
lower blood pressure and
cholesterol
In addition to being a low salt (or
low sodium) plan, the DASH diet
provides additional benefits to
reduce blood pressure. It is a high
fiber, low to moderate fat diet, rich
in potassium, calcium, and
magnesium.
Foods to be avoided:
Salt in cooking or at the table,
ajinomoto. baking powder,
preserved foods such as pickles,
canned foods, potato chips, papads,
ketchup, sauce, baked foods such
as biscuits, cakes, peanut butter,
frozen peas, shell fish, and dry fish,
etc.
DIET SUGGESTED BY DASH
The DASH diet emphasizes portion
size, eating a variety of foods and
getting the right amount of
nutrients.
Dash Diet Phase 2 Portion Sizes
DASH diet Grains (6 to 8 servings a
day) Grains include bread, cereal,
rice and pasta.
Focus on whole grains because they
have more fiber and nutrients than
do refined grains. For instance, use
brown rice instead of white rice,
whole-wheat pasta instead of
regular pasta and whole-grain
bread instead of white bread.
Grains are naturally low in fat, so
avoid spreading on butter or adding
cream and cheese sauces.
Vegetables (4 to 5 servings a day)
dish diet Tomatoes, carrots,
broccoli, sweet potatoes, greens
and other vegetables are full of
fiber, vitamins, and such minerals
as potassium and magnesium
phases.blogspot.com/
Examples of one serving include 1
cup raw leafy green vegetables or
1/2 cup cut-up raw or vegetables
Fruits (4 to 5 servings a day)
➤ Many fruits need little
preparation to become a healthy
part of a meal or snack.
Like vegetables, they're packed
with fiber, potassium and
magnesium and are typically low in
fat-exceptions include avocados
and coconuts.
Examples of one serving include I
medium fruit or 1/2 cup fresh fruit.
Dairy (2 to 3 servings a day)
Milk, yogurt, cheese and other
dairy products are major sources of
calcium,
vitamin D and protein. Choose dairy
products that are low-fat or fat-
free.
Examples of one serving include 1
cup skim or 1 cup yogurt or 1 1/2
oz. cheese
Lean meat, poultry and fish (6 or
fewer servings a day)
Meat can be a rich source of
protein, B vitamins, iron and zinc.
But because even lean varieties
contain fat and cholesterol, don't
make them a mainstay of your diet
Examples of one serving include 1
oz. cooked skinless poultry, seafood
or lean meat, 1 egg./tuna.
Trim away skin and fat from meat
and then broil, grill, roast or poach
instead of frying. Eat heart-healthy
fish, such as salmon, herring and
tuna.
These types of fish are high in
omega-3 fatty acids, which can help
lower your total cholesterol.
Alcohol and Caffeine
Drinking too much alcohol can
increase blood pressure. drinks a
day
The DASH diet recommends that
men limit alcohol to two or fewer
and women one or less.
FIBER
Getting the recommended daily
amount-22 to 34 grams for adults
helps you feel full and promotes
good digestion. DASH provides
more than enough.
Nuts, seeds and legumes: 4 to 5
servings a week Almonds,
sunflower seeds, kidney beans,
peas, lentils and other foods in this
family are good sources of
magnesium, potassium and protein
and full of fiber and
phytochemicals,
They contain healthy types of fat-
monounsaturated fat and omega-3
fatty acids.
DIABETIC DIET PLAN MANAGING
DIABETES WITH HEALTHY DIET
Importance of proper diet in a
Diabetic Patient:
1. To provide adequate nutrition.
2. To control blood sugar and lipids.
3. To maintain ideal weight.
4. Less medication.
5. To prevent complications.
Key pieces of diabetes self-
management:
Monitoring blood glucose
Taking medication
Following a meal plan
Getting regular exercise
Fats
Are concentrated forms of energy.
• 3 types-saturated
monounsaturated and
polyunsaturated.
• Saturated=ghee, butter, coconut
oil-taken in small quantities. 20-
25% of total daily intake of calories.
Dietary fiber
Part of food not digested in the gut-
unavailable carbohydrate.
Eg-Whole grains, ragi, jowar, oats,
green leafy vegetables. Help reduce
blood glucose, serum cholesterol,
relieve constipation.
Intake of 25 gm dietary fiber per
1000 cal. -optimum
Carbohydrates
Diabetics-not restrict the
carbohydrate intake but alter the
carbohydrate type.
Eg-cereals, pulses -complex sugars.
• Sugar, jaggery, honey and jam -
simple sugar.
55-60% of total daily intake of
calories.
Proteins
Proteins can be obtained from-
meat, pulses, legumes,milk. They
help to reduce the blood glucose
and lipids. 10-15% of total daily
intake of calories.
Glycemic index
Area under the 2 hour blood
glucose response curve(AUC)
following the ingestion of a fixed
portion of test carbohydrate (50g)
as a proportion of the standard
either glucose or white bread.
Low GI(55 or less)
1-Fruits, veg except potato,
watermelon).
2-Whole grains, beans
3- Lentils
Medium GI(55-69)
1-Sucrose
2-Basamati Rice
3-Brown Rice
High GI(70 or more)
1-Baked potato
2-White bread
3- Syrupy foods
4-Candies
Permissible Foods
1-Green leafy vegetables
2-Seasonal vegetables
3-Soups
4-Dairy products(Skimmed)
5-Fruits Apple, guava, pear, papaya.
6-All Pulses -Husked
Non Permissible Foods
1-Sugar, jaggery, honey.
2-Potato, beetroot, arvi, sweet
potato
3-Fried,canned foods, processed
foods
4-Soft drinks, ice creams, fruit juice
MODIFICATIONS:
Food used liberally
Food in moderate amounts
Food to be avoided
HEART-HEALTHY DIET: WHAT IS IT,
WHAT CAN YOU EAT AND WHAT
SHOULD YOU AVOID?
WHAT ARE SOME RECOMMENDED
CARDIAC DIETS?
SEVERAL HEART-HEALTHY DIETS
ARE HIGHLY RECOMMENDED FOR
CANCER PATIENTS AND FOR
ANYONE WANTING TO IMPROVE
THEIR HEART HEALTH. THESE
INCLUDE THE DASH (DIETARY
APPROACHES TO STOP
HYPERTENSIONI DIET, THE
MEDITERRANEAN DIET, AND MANY
VEGETARIAN DIETS.
CARDIAC DIET
"CARDIAC DIET" IS AN UNOFFICIAL
TERM FOR A HEART-HEALTHY DIET.
IT'S AN EATING PLAN THAT
EMPHASIZES FOODS THAT
PROMOTE HEART HEALTH, SUCH AS
VEGETABLES AND FRUITS, WHOLE
GRAINS. LEAN POULTRY AND OILY
FISH LIKE SALMON AND TUNA THAT
ARE HIGH IN OMEGA-3 FATTY
ACIDS. THE DIET ALSO LIMITS
PROCESSED FOODS THAT ARE HIGH
IN SUGAR, SALT AND UNHEALTHY
FATS, BECAUSE THESE INCREASE
THE RISK OF HEART DISEASE.
MEATS AND OTHER PROTEINS
SEAFOOD - FISH (ESPECIALLY
VARIETIES RICH IN OMEGA-3 FATTY
ACIDS) LIKE SALMON, MACKEREL
HERRING AND LAKE TROUT
POULTRY - CHICKEN OR TURKEY
BREAST WITHOUT SKIN, OR LEAN
GROUND CHICKENOR TURKEY (AT
LEAST 93% LEAN)
LEAN MEATS - PORK SHOULDER,
BEEF SIRLOIN, OR LEAN GROUND
BEEF (AT LEAST 93% LEAN)
BEANS, PEAS, AND LENTILSEGG
WHITES OR EGG SUBSTITUTE
UNSALTED SEEDS AND NUTS
TOfu
WHOLE GRAINS
WHOLE GRAIN BREAD, BAGELS,
ENGLISH MUFFINS, AND TORTILLAS
WHOLE GRAIN HOT OR COLD
BREAKFAST CEREALS WITH NO
ADDED SUGAR, LIKE OATMEAL OR
SHREDDED WHEAT
WHOLE GRAIN BROWN OR WILD
RICE, OR QUINOA WHOLE WHEAT
OR WHOLE GRAIN PASTA AND
COUSCOUS
CHOOSE PRODUCTS WITH THE
WORD "WHOLE" IN THE FIRST
INGREDIENT FOR EXAMPLE,
"WHOLE WHEAT," "WHOLE GRAIN"
OR "WHOLE OATS."
VEGETABLES AND FRUITS
ALL FRESH VEGETABLES AND LEAFY
GREENS
ALL CANNED VEGETABLES (RINSE
TO REMOVE SALT, OR CHOOSE "NO
SALT ADDED") • FROZEN
VEGETABLES WITHOUT ADDED
BUTTER OR SAUCES ALL FRESH
FRUITS CANNED, FROZEN, OR
DRIED FRUIT WITHOUT ADDED
SUGARS
DAIRY
LOOK FOR FAT FREE OR LOW-FAT
OPTIONS.
SKIM OR LOW-FAT (1%) MILK
*FAT FREE OR LOW-FAT PLAIN
YOGURT
FAT FREE OR LOW-FAT CHEESES OR
COTTAGE CHEESE
HEALTHY FATS AND OILS
UNSATURATED VEGETABLE OILS
(OLIVE, CANOLA, SAFFLOWER,
PEANUT, SUNFLOWER OR
AVOCADO)
LOW-FAT OR LIGHT MAYONNAISE
OIL-BASED, NON-CREAMY SALAD
DRESSINGS LIKE BALSAMIC
VINAIGRETTE OR ITALIAN SOFT
MARGARINES IN TUBS, NOT STICKS
AVOCADOS
BEVERAGES
• WATER (PLAIN OR FLAVORED TROPICAL OILS LIKE COCONUT,
WITH FRUIT SLICES) PALM AND PALM KERNEL OIL
SPARKLING WATER BEVERAGES
COFFEE DRINKS WITH ADDED SUGARS
•TEA ALCOHOL
WHICH FOODS SHOULD I LIMIT HEART HEALTHY DIETS ALSO LIMIT
WHILE ON A CARDIAC DIET? SODIUM, WHICH BUMPS UP YOUR
BLOOD PRESSURE AND MAKES
GRAINS YOUR HEART WORK HARDER.
BAKED GOODS LIKE CAKES,
COOKIES, MUFFINS, SCONES,
BISCUITS, CROISSANTS, COBBLERS,
DOUGHNUTS, PASTRIES AND PIES
"WHITE RICE, BREAD AND PASTA
SNACKS CONTAINING PARTIALLY
HYDROGENATED OILS. THIS
INCLUDES SOME POTATO CHIPS,
CRACKERS, SNACK MIXES, CHEESE
PUFFS AND MICROWAVE
POPCORN.
MEATS AND OTHER PROTEIN
HIGH FAT CUTS OF BEEF (REGULAR
GROUND MEAT, RIBS, T-BONE AND
RIBEYE STEAKS)
*PROCESSED MEATS LIKE HOT
DOGS, SAUSAGE, SALAMI, LUNCH
MEAT, BACON *ORGAN MEATS
(LIVER, BRAINS AND
SWEETBREADS)
*FRIED CHICKEN OR FISH POULTRY
WITH SKIN
WHOLE EGGS
DAIRY
FULL-FAT CHEESE *CREAM CHEESE
WHOLE OR 2% MILK
WHOLE MILK YOGURT
*ICE CREAM
CREAM OR HALF-AND-HALF
FATS AND OILS
• BUTTER
STICK MARGARINE
SHORTENING